Peter Suderman on Ending Medicare As We Know It

House Republicans, you may have heard, are trying to "end Medicare as we know it." And well they should—Medicare as we know it is the nation's biggest fiscal disaster. And despite the potential campaign effectiveness of the political charge that Republicans want to gut Medicare, President Barack Obama has positioned himself as a willing butcher of his own party's sacred cow. "We have to tackle entitlements" to control the federal debt, the president said in June, and "Medicare has to bear a greater part of the burden."

So what innovative solution does Obama propose to begin fixing America's biggest fiscal problem? Simple: He would change the way providers are paid for Medicare's services. Pay less, spend less. Right? Wrong, says Associate Editor Peter Suderman. Since the birth of the entitlement, Suderman writes, a parade of legislators and bureaucrats has been playing billion- and trillion-dollar games of Whac-A-Mole with Medicare, knocking down spending with an elaborately constructed set of technocratic payment schemes in one area only to see it rise back up in some other part of the system. Obama is merely proposing to try it one more time.